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SHORT-TERM RENTAL LICENSE APPLICATION — Burnett County, WI c r C* <br /> -. <br /> 21 <br /> G CD e <br /> Applicant Complete All Sections Below This Line y. p <br /> H <br /> Original License Fee= $300 Renewal License Fee (Annually)= $150 0- <br /> d <br /> Property Owner's Name: e%-F9.. /004;ct Plet_co�., 2, CT <br /> Q � <br /> Property Owner's Mailing Address: I ZZ S E� r S on ��l cc c ( S�oo� 'u� w't• 5-c/go/ <br /> �/� l .-1,4. <br /> ity State Zip ''� <br /> Property Site Address: ((�( Y rSC'r. 7� cti ( -;aorta. \ , <br /> W <br /> Applicant's Telephone Number: (2 —2 qQ z(, z D o r <br /> Applicant's Email: eeji illA fl e.F (a) t -, t a r 1.. co ems.. <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b o <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and . g <br /> @BumettCountyWl.gov 5• <br /> Legal Description of Property:et'Ic+Z LYt y nd .5 c'4( 4 C3 rn Seo (Ai PS Fri e5 n 5e -' �f q <br /> CD <br /> Section#: I3 Town#: '40 N Range#: /( W Town of:_ S c(-{---}- 0'7 — <br /> 5.. <br /> I� -- <br /> W .a. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* G <br /> Tax ID#(1-5 digit number; found on tax statement):_.35795 4• E A o <br /> . e1 <br /> Provide Rental Information C <br /> License Year Applied For: 2 ei 3 Amount of Renters Applied For: C., <br /> 0 ' P. <br /> Local Contact's Name: .Z,LifK. A V Cam-- <br /> Local Contact's Address: 12�5 l9- rSo;^ (r(6t:// 5 '`''f'�'. £0 c go 1 <br /> City State Zip <br /> Local Contact's Telephone Number: 6_(2^2.46 26 7 el M pet.1-C N N iq C2 w <br /> Most Recent Burnett County License Number: STR- State License Number:717 z- -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS LICENSE IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> — LI eta( - e i /t3 \ ki /zoz -i o <br /> z <br /> - 0 ciAxeand cind oAv--1-;zm 4+ not -0 -excee,d Le pe <br /> -1,40(1 and Cik n 00 S.e O 4 -aril k (S) obi- a tA --h <br /> Cl) <br /> - Wkto , U Ictuurd V reA40-k uA d L l( Itc 1� nu►� Fee Re <br /> c: 1 1:1) <br /> P P IP `� o <br /> a,nu �`1 , I 1 IZo2 • L;e• ! (.1...-) M. 2 . m1n <br /> Followl i n9 r Q fur n°��k-e.4'��-5 <br /> Date of staff site visit: ✓?, 2/20Z3 Initials of site visit staff: Kr— <br /> o <br /> LICENSE APPROVED BY :ca!�`r'{�41(1/ M DATE: I 0/Z2 { m c° M. <br /> til C <br /> LAND SERVICES OFFICIAL n m CD <br /> m o ff <br /> ril <br /> Page 1of3 N II., N Burnett County, WI Short-Term Rental License Application—Rev 12/2022 i w <br /> m <br /> m ` J <br />